Public Benefits During COVID Pandemic
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Table of Contents
Medicare is the federal health insurance program for people 65 or older, recipients of Social Security Disability Insurance benefits, and those with End-Stage Renal Disease. Types of Medicare coverage are organized into different “parts”:
• Part A is hospital insurance and covers hospital stays, hospice care, and skilled nursing care a person may need to rehabilitate after being hospitalized.
• Part B is medical insurance and covers doctor visits, lab tests, diagnostic screenings, medical equipment, ambulance transportation, and other outpatient services.
• Part C is another name for Medicare Advantage. Part C is managed by private insurance companies and bundles together services covered by Part A and B with extra benefits.
• Part D pays for some prescription drugs and is also managed by private insurance companies.
What if I need skilled nursing care after a hospitalization?
Medicare has suspended the 3 hospital overnights requirement. Beneficiaries who have recently used all their skilled nursing days can also ask for more days without having to start a new benefit period.
What if my durable medical equipment has been lost or damaged?
Durable medical equipment providers have the flexibility to waive replacement requirements. This means the face-to-face requirement, a new doctor’s order, and a new medical necessity documentation is not required.
Medicare denied payment – what can I do?
If you disagree with a coverage or payment decision, you can appeal. Your deadline for filing an appeal depends on which part of Medicare (A, B, C, or D) you are appealing. Currently, appeal deadlines for Medicare Advantage (Part C), fee-for-service (Part C), and Part D have been extended. Medicare will also process appeal requests using the information available even if it does not meet all the requirements.
Be aware of scammers – guard your Medicare card and number just like you would a credit card. Check Medicare claims summary forms for mistakes. Do not give your Medicare number to anyone calling you over the telephone.
What am I responsible for paying during the emergency declaration?
Effective March 13, 2020, DHS waived all co-pays, premiums, and contributions for Iowa Health and Wellness Plan, Medicaid for Employed People with Disabilities (MEPD), Health and Well Kids in Iowa (Hawki), and Dental Wellness Plan (DWP) members. Billing statements from DHS with March, April, May, or June due dates are waived. Members who have already paid their co-pay, premium or contribution for a waived month will receive a credit on their account when billing resumes. There is no cost for COVID 19 testing.
Also, any member who has overdue Hawki premium payments for January 2020 and/or February 2020 will be required to pay these amounts before receiving services again.
How can I stay healthy and socially distance by staying home?
Medicaid will cover telehealth services. Out-of-network doctors will also be covered when medically necessary. Prior authorization for COVID 19 testing is not required and there are no limits on medically necessary treatment for COVID 19. You may also be able to fill your prescriptions for an extended period of time.
While Governor Reynolds signed a proclamation suspending elective and nonessential medical and dental procedures, doctors and dentists are now allowed to perform certain procedures as long as they have a sufficient supply of protective equipment. You should stay in touch with your medical provider regarding any procedure you are scheduled to have and what alternatives might be available.
Will my Medicaid coverage continue?
DHS has temporarily paused all terminations for medical assistance programs until the emergency declaration is lifted, although Medicaid members may be moved from one Medicaid program to another. “Healthy behavior” requirements under the Dental Wellness Program are suspended. Children who age out of Hawki will be automatically enrolled in Iowa Health and Wellness.
How is facility Medicaid coverage effected?
For those who currently receive facility Medicaid, DHS will not disenroll you if you have not spent down your resources to under the $2,000 resource limit. However, any new applicants still have to meet all income and eligibility requirements before they are eligible. Client participation for facility care and PACE is not waived and participants need to continue making those monthly payments.
How are Medicaid waiver services affected?
DHS is allowing a parent, legal guardian, or immediate family member to provide Home and Community Based Services (HCBS) for the duration of the COVID 19 emergency. Members should work with their case managers on any changes that need to be made to their service plans. If a “shelter in place” order is issued, HCBS staff are considered essential workers and would be able to continue providing care. DHS will continue to process new HCBS applications, but with some changes. interRAI, the provider who does the in-person evaluations as part of the application process, has issued guidance about performing these assessments through live video stream.
My Medicaid eligibility is based on my employment under the Medicaid Employed People with Disabilities (MEPD), but I cannot work right now due to COVID 19.
Work requirements are currently suspended for MEPD.
How will my immigration status be affected if I use Medicaid to get treatment for COVID 19?
U.S. Citizenship and Immigration Services (USCIS) has said that it will not consider “testing, treatment, or preventative (including vaccines, if a vaccine becomes available)” related to COVID 19) in any Public Charge determinations. This guidance applies to immigrants applying for lawful permanent resident status (green card), extension of stay, or change of immigration status.
Coverage of COVID-19 Testing
- The federal Families First Coronavirus Response Act and the CARES Act provide for COVID-19 testing without cost-sharing or prior authorization.
- There is a DHS application for free testing: https://secureapp.dhs.state.ia.us/dhs_titan_public/covid/application. For those who qualify, the program will cover the cost of testing only, not treatment.
- No co-pays for Medicaid COVID-19 testing.
- No out of pocket costs for Medicare COVID-19 testing https://www.medicare.gov/coverage/coronavirus-test
- Several Iowa health insurance companies have announced that they will waive cost-sharing for COVID-19 testing
- Medica https://www.medica.com/newsroom/press-releases/2020/03092020-medica-waives-all-cost-sharing-for-covid19-testing
- Aetna https://www.aetna.com/individuals-families/member-rights-resources/need-to-know-coronavirus.html#acc_link_content_section_responsivegrid_copy_responsivegrid_accordion_1336905482_1
- Wellmark https://www.wellmark.com/coronavirus
- UnitedHealthcare https://www.uhc.com/health-and-wellness/health-topics/covid-19
DHS has asked the federal government to allow it to increase benefits to current and new SNAP recipients. A new federal law will allow DHS to do the following:
- Increase for 2020 months (April through December) and January and February 2021 Food Assistance benefits to the maximum allowable amount per household.
- If a household is not already receiving the maximum amount for April through December 2020, or January or February 2021, those additional benefits will be added to their EBT card with their normal monthly benefits. You can view the maximum amounts here.
- Adjust Food Assistance eligibility requirements and benefits to address the loss of school lunch
- DHS is working collaboratively with the Department of Education to research opportunities related to increased food insecurity for Iowa families who rely on school lunch programs.
I have a recertification coming up soon. Do I have to submit paperwork for it?
People who were supposed to have their SNAP recertified in March, April, May, or June 2020 will have their cases automatically renewed. DHS did not send out notices of decision to households about this.
I am required to work to keep food assistance but I lost my job or my hours were cut. Will I lose my food assistance?
DHS is waiving the requirement to work during this public health emergency.
I have SNAP benefits, but don’t want to go to a crowded grocery store to get food. What can I do?
What if I don’t qualify for food assistance?
Iowans who need emergency assistance due to an income change are now eligible for The Emergency Food Assistance Program (TEFAP). Iowans who need food should call 2-1-1 or contact their local food bank to find TEFAP providers in their area.
How do I check the amount of benefits on my Food Assistance EBT card?
DHS has information about how to do this on their website: https://dhs.iowa.gov/food-assistance-COVID19
I lost my Food Assistance EBT card, how do I get a new one?
You can call 1-800-359-5802, 24 hours a day, 7 days a week to get a new card mailed to you.
How do I apply for Food Assistance?
You can apply for Food Assistance or FIP benefits on the DHS website here.
I am supposed to have a review in March, April, May, or June. Do I still have to do the paperwork for that?
DHS suspended reviews for the months of March, April, May, and June 2020. All March, April, May, and June 2020 Food Assistance and FIP cases that were due for renewal were automatically given six more months of eligibility. DHS will send the review forms to you closer to the new renewal date.
- March cases were to have review forms due in September.
- April cases were to have review forms due in October.
- May cases were to have review forms due in November.
- June cases were to have review forms due in December.
How do I report any changes?
Call the DHS Call Center at 1-877-347-5678 to report changes. DHS can then act on the reported changes and update your benefits.
I lost my FIP Mastercard, how do I get a new one?
You can call 1-844-207-3225, 24 hours a day, 7 days a week, to get a new card mailed to you.
How do I check the amount of benefits on my FIP Mastercard?
DHS has information about how to do this on their website.
How do I apply for FIP benefits?
You can apply for Food Assistance or FIP benefits on the DHS website.
Iowa Legal Aid provides help to low-income Iowans.
To apply for help from Iowa Legal Aid:
- Iowans age 60 and over, call 800-992-8161.
- Apply online at iowalegalaid.org